Pomona, Calif. - 04/30/2012 --
Doctors and pharmacists can learn a lot from each other, especially when it comes to managing patient medications and preventing medication errors. Drug therapy has gotten so complex that the Institute of Medicine found in a 2006 report that at least 1.5 million Americans are sickened, injured or killed annually by their prescription drugs.
To help with this intricate drug management issue, the College of Pharmacy at Western University of Health Sciences in Pomona, Calif., is collaborating with preceptors Dr. Bryn Henderson and Pharmacist R. Wayne Blackburn to create the Family Practice Medication Therapeutic Management (MTM) Collaborative Program.
Under the auspices of Blackburn and College of Pharmacy Assistant Professor of Clinical Practice and Administration Roger Klotz, third-year College of Pharmacy student Danielle Arredondo recently started her the ambulatory care rotation at Dr. Henderson's Telehealth Medical Group, a family medicine practice in Orange, Calif.
"PharmD students rotate in a family medicine practice to learn how to evaluate the medication that patients are taking," Henderson said. "I believe this is the first program of its kind in the United States."
Henderson, a former professor and assistant dean of Clinical Affairs for the College of Osteopathic Medicine of the Pacific (COMP) at WesternU, says this is a unique experience for him and for the student, because they learn from each other.
Before Arredondo arrives for work at Dr. Henderson's practice, she has determined her patients' medications by calling them the day before to ensure accuracy. Then Henderson, Blackburn and often a resident or two discuss the medications and the next steps for the patient.
Two COMP graduates, Jose Dalprat, DO '10, and Amine Chahbouni, DO '09, are residents at Dr. Henderson's office through Downey Regional Medical Center.
"The university's benefit is having a broader scope of experience levels or training levels for our students," Klotz said. "The practice and the university are helping to implement collaborative practice, or accountable care organizations. What we're going to learn can be applied across the country. We can better teach pharmacy students and pharmacists how to work collaboratively with medicine, and vice versa."
Using a medical practice to teach pharmacy students has not previously been done outside of a hospital or institution, Klotz and Henderson said.
Arredondo is the first WesternU pharmacy student to start the program. Klotz said it would be a regular rotation that will expand to more students and practices.
As the rotation grows, Family Practice Medication Therapeutic Management (MTM) Collaborative Program recognizes issues to help improve it:
- Access to information- Disparity between the information on an electronic medical record (EMR) and other information being used, including medications the patient is taking that are different than what is on the EMR. Lack of communication between prescribing physicians creates a disparity of information in lab values and prescribed medications.
- Time constraints- The most accurate way to assess what medications a patient is taking is simply to ask them right before Dr. Henderson sees them, which is not ideal because of the challenge of making a good clinical assessment and evaluation in such a small time frame.
- Cost- All insurances have formularies of medications that are covered, but physicians and pharmacists do not have access to these formularies. This challenges health care providers because it limits a clinician's decision-making ability and affects prescription affordability.
- Scope of curriculum/knowledge- The scope of practice of pharmacists has vastly expanded within the last 10 years.
Klotz says it's critical that students be exposed to this relationship and hands-on experience because it is what WesternU is teaching through its Interprofessional Education (IPE) program.
WesternU's IPE program brings together students from nine different disciplines in the classroom, in small group venues and in clinical experiences with patients.
"This is the first experience where I've had the collaboration with physicians," Arredondo said. "It's exactly like the real-life implementation of IPE. We go through patients' charts, talk about the best treatment for them. I assess their renal function and their hepatic function, and that's how I recommend certain medications or not."
Arredondo says she never expected such close interaction when she began her rotation, but it's been beneficial to see how physicians diagnose patients.
"I really think it's a great way to better care for patients, because you have that really close interaction with a physician and the pharmacist, and that's really rare," she said.